Epidemiological Week 9(Week ending 5thMarch, 2018)

Highlights Cumulative figures as of week 9

• Total of 196 Health Facilities across have submitted weekly report of communicable diseases in the electronic early • 547,303 cumulative week 1 to week 9 warning disease surveillance system in week 9, 2018. cases of all diseases • Total number of consultations decreased from 55,775 in week 8 • 1,313 cumulative cases of AWD and 8 to 51,174 in week 9. • The highest number of diseases in week 9 were: other acute deaths since December 2017. diarrhoeas (2,061 cases), influenza like illness (1,697 cases) followed by severe acute respiratory illness (1,038 cases) • 3,555 cumulative cases of suspected • A total of 174 new cases of AWD with no deaths were reported in measles cases since the beginning of week9 compared to 148 AWD cases no deaths death in week 8. 2018. • A cumulative total of 1,3131 cases including 8 deaths have been • Of the 3,555 measles cases, 2,220 (62%) reported since December 2017. are under 5 years while 1,335 (38%) are • The new AWD/cholera cases reported in Beletweyne started in above 5 years December 2017. All the new outbreaks in Banadir, Kismayo and Jowhar started in 2018 • The number of measles cases decreased from 586 in week 8 to 447 cases reported in week 9.

Disease Wk7 2018 Wk8 2018 Wk9 2018 Cumulative cases (Wk 1 – 9, 2018) Total consultations 56447 55775 51,174 547,303 Other Acute Diarrheas 2006 2068 2061 20073 Influenza Like Illness 1890 1787 1697 18,556 Severe Acute Respiratory Illness 963 1112 1038 8,336 Suspected Measles 355 586 447 3555 Confirmed Malaria 205 142 108 2223 Acute Watery Diarrhoea 60 62 74 673 Bloody Diarrhea 61 38 56 421 Whooping Cough 81 104 23 416 Acute Jaundice 0 5 2 36 Suspected Meningitis 1 3 3 23 Diphtheria 13 6 1 23 Neonatal Tetanus 0 0 0 17 Acute Flaccid Paralysis 0 0 0 1 Viral Hemorrhagic Fever 0 0 0 2

Total number of Consultations and number of reporting sites

1 The Cases of AWD/Cholera in the eWARN system are collected from sentinel sites. while the cases of AWD/cholera in Sitrep are collected from temporary CTC sites which doesn't include the Sentinel sites

Completeness of Reporting Out of 265 Health Facilities expected to submit weekly report of communicable diseases in the electronic early warning disease surveillance system across Somalia, 196 reported data in week 9. Thus the completeness of reporting about 74%. A total of 51,174 consultations were recorded in week 9, 2018. (See fig1)

Chat 1: Consultations and reporting sites, week 1 to 8, 2018 800 80,000

700 70,000

600 60,000

500 50,000

400 40,000 Consultations

Reporting sites Reporting 300 30,000

200 20,000

100 10,000

0 0 WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9

Consultations Reporting sites

Proportionate morbidity

Other acute diarrhoeas, influenza like illness Severe Acute respiratory illness, suspected measles and Malaria are the commonest causes of morbidity across Somalia in 2018. In week 9, the highest number of diseases: other acute diarrhoeas (2,061 cases), influenza like illness (1,697 cases) followed by severe acute respiratory illness (1,038 cases) Chart 1. Commonest causes of morbidity during week 1 to 9

3000

2500

2000

1500

1000

500

0 Wk1 2018 Wk2 2018 Wk3 2018 Wk4 2018 Wk5 2018 Wk6 2018 Wk7 2018 Wk8 2018 Wk9 2018

other acute Diaria influence like illness Severe Acute Respiratory Illness Suspected Measles Confirmed Malaria

Situation update of AWD/Cholera

AWD/Cholera situation in different regions of Lower Jubba ,Hiiran, and Banadir

Over the past 13 Weeks, there has been a significant increase in the number of AWD/Cholera cases reported

Districts Reporting Cases in Week 9 in four regions (Banadir, Lower jubba Middle Shabelle and Hiiran). In week 9, active transmission of AWD/cholera was reported in Beletweyne district of Hiraan region, Middle Shabelle and Lower jubba district Kismayo as well as in 10 districts of Banadir region. In Hiraan, Kismayo and Jowhar affected communities are reportedly using contaminated water from open water sources. The AWD outbreak that was reported in Beletweyne in December 2017 is responsible for the spread to other regions that are all located at the banks of river shabelle. The Oral Cholera Vaccination that was implemented in 11 high risk districts of the central region has greatly contributed to the reduction in the number of new AWD/cholera cases according to last year.

Fig 1. AWD/Cholera cases in Somalia Feb 2017-Feb 2018 5000 5.00

4500 4.50

4000 4.00

3500 3.50

3000 3.00

2500 2.50 CFR 2000 2.00

Number of AWD/Cholera casesAWD/Cholera of Number 1500 1.50

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0 -

WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 1 WK 2 WK 3 WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK

WK 10 WK 11 WK 12 WK 13 WK 14 WK 15 WK 16 WK 17 WK 18 WK 19 WK 20 WK 21 WK 22 WK 23 WK 24 WK 25 WK 26 WK 27 WK 28 WK 29 WK 30 WK 31 WK 32 WK 33 WK 34 WK 35 WK 36 WK 37 WK 38 WK 39 WK 40 WK 41 WK 42 WK 43 WK 44 WK 45 WK 46 WK 47 WK 48 WK 49 WK 50 WK 51 WK 52 WK Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb 2007 2018 weeks

Total Total CFR

Table 2. Summary of AWD/Cholera cases in different regions Week 8 Week 9 Cumulative as of Epi- Week 49, 2017, Wk Region (19th -25th Feb 2018) (26th Feb to 4th Mar 9. 2018) 2018 Cases Deaths CFR (%) Cases Deaths CFR (%) Cases Deaths CFR (%) Hiraan 8 0 0 10 0 0 515 1 0.2

Banadir 51 0 0 48 0 0 405 2 0.5

Lower Jubba 29 0 0 33 0 0 193 3 1.6

Middle Shabelle 60 0 0 83 0 0 200 2 1.0

Total 148 0 0 174 0 0 1313 8 0.6 The AWD/Deaths reported in this table have not been confirmed by stool analysis.

Cholera Situation in Hiraan, Lower Jubba, Middle Shabelle and Banadir. • The current AWD/Cholera event started in Beletweyne districts in December 2017 and continued in 2018. There has been an observed reduction in the number of new AWD/Cholera cases in Beletweyne over the past weeks with only 10 cases and no deaths reported in week 9. 90% of all the affected cases in Beletweyne are children below 5 years. Only 4% of the AWD/Cholera cases reported in Hiraan received OCV vaccination during the campaign that was conducted in Xaawo Taako and Koshin in March 2017 • The AWD/Cholera outbreak in Banadir region started in week 1 of 2018 following reports of similar outbreak in Hiraan. Banadir region is one of the regions with the highest concentration of IDPs where access to safe water and sanitation facilities are limited. Of the 15 districts that make up Banadir region, 10 have so far reported cases and these are managed in Banadir CTC located in the capital Mogadishu. • Lower Jubba is one of the cholera hotspots in Somalia located at the border with Kenya in the South. The current AWD/Cholera outbreak in started in week 5 of 2018 in the IDP communities of Farjano where access to safe water and sanitation is also limited. The district is characterised by returnees from Kenya as well as those displaced by war in Middle Jubba. Even when OCV was implemented in Kismayo in March 2017, the reported cases of AWD/Cholera did not receive OCV. This may be attributed to these being new cases who were absent during the time of the vaccination • Middle shabelle region is one of the cholera hot spots for the past decade with limited access to safe water and sanitation. The new AWD/Cholera outbreak in Middle Shabelle started in week 7 of 2018 and the most affected villages of Hantiwadag, Kumis , Bulo Sheik and Horseed. of the 200 cases so far reported, 51% are children below 5 years.

Table 3. Distribution of AWD/cholera cases per district in Somalia (Dec.2017 - March. 2018) Week 9 26th Feb- 4th Mar - 2018 Cumulative (week 1-9- 2018) Region District cases <5yrs cases Deaths CFR (%) Live Deaths CFR (%) >5yrs Heliwaa 0 0 0 0 3 0 0 Banadir Daynile 5 4 0 0 64 2 3.1 Hamar Weine 0 0 0 0 4 0 0 HamarJabjab 1 1 0 0 12 0 0 Dharkenley 3 2 0 0 56 0 0 Hodan 5 4 0 0 111 0 0 Howlwadag 2 0 0 0 14 0 0 Karan 5 0 0 0 10 0 0 Madina 8 0 0 0 92 0 0 Shibis 0 0 0 0 3 0 0 waberi 3 1 0 0 17 0 0 Wardigley 1 2 0 0 11 0 0 Yaqshid 1 0 0 0 8 0 0 Hiiran Beletweyne 3 7 0 0 515 1 0.2 Lower Jubba Kismayo 19 14 0 0 193 3 1.6 Middle Shabelle Jowhar 34 49 0 0 200 2 1.0 Total 90 84 0 0 1313 8 0.6

Response activities implemented during the week

Coordination and Leadership • Weekly meetings were held in Banadir hospital CTC between Ministry of Health, Health and WASHcluster partnersto plan for the implementation of response activities. • A coordination meeting was held between health cluster and Wash cluster partners in Jowhar Middle Shabelle Case management and Oral Cholera Vaccination • The cholera treatment facilities Middle Shabelle in Banadir,Kismayo and Beletweyne have been opened to manage AWD/Cholera cases reported from affected districts • 11 Alerts/rumors have received and investigated from Beletweyne • 420 people have reached in Beledweyn as Buloburte reached 210 people in MCH level.. Surveillance and Laboratory Investigations • 4 regional rapid response Teams in affected regions have been deployed to verify and investigate AWD/Cholera rumors in all the affected regions/districts • AWD/Cholera alerts are being received from different regions using the newly activated EWARN system. • Of the 10 stool samples collected,9 of them were positive for V.cholerae Water Sanitation and Hygiene • Community education was conducted in crowded areas of Banadir,Jowhar,Kismayoand Beletweyne district.

Update on OCV campaign in Hudur and Afmadow

• Save the children International (SCI) with support from WHO and FMOH conduct the first round of the Oral cholera vaccination campaign in Hudur and Afmadow between 11th Feb to 18th Feb 2018 • Of the 193,320 people targeted for Vaccination in the 2 districts, 176,037 (91%) persons aged one year and above received the first dose of which 98,567 were from Afmadow while 77,470 were from Hudur • Of the 176,037 people who received the first dose of OCV, 48,326 (27%) where aged 1-4 years, 30% were aged 5-10 years while 73,208(42%) were aged 15 years and above • The OCV campaign in Afmadow was an integrated approached where hygienic kits were distributed to the target population • Social mobilisation activities were implemented 2 days prior to the campaign and throughout the campaign period • A mixed strategy of door to door and fixed posts using existing Polio structures where used by vaccination teams to reach the target population • A total of 10 fixed teams, 23 mobile teams as well as 25 house to house teams were used to implement the campaign following a 2-day training exercise by the MoH trainers • No adverse events following Immunisation (AEFI) were reported following the first round of the OCV campaign • The second OCV campaign will be conducted between 11th and 18th March 2018

Measles Situations

The number of suspected measles cases decreased from 586 cases in week8 to 447 cases in week 9. Cumulatively, 3,555 cases of suspected measles have been reported across Somalia since the beginning of the year, 2018. Of the 3,555 measles cases, 2,220 (62%) are under 5 years while 1,335(38%) are above 5 years. The most affected regions include Galgadudd (704cases), Bay (539 Cases) Banadir (514 cases), and (344 Cases), (See Table 4).

Somalia, Suspected Measles Cases as of Week 1-9, 2018 700 600 500 400 300 200 100 0 Wk1 2018 Wk2 2018 Wk3 2018 Wk4 2018 Wk5 2018 Wk6 2018 Wk7 Wk8 2018 Wk9 2018

Table 4: Summary of Suspected measles cases by region week 1 - 9, 2018

Region Wk1 Wk2 Wk3 Wk4 Wk5 Wk6 Wk7 Wk8 Wk9 Cumulative 2018 2018 2018 2018 2018 2018 2018 2018 2018 cases (Wk 1 – 9)

Awdal 2 0 0 0 5 0 1 1 1 10 11 21 17 21 6 9 7 3 7 102 Banadir 75 66 57 68 49 57 54 54 34 514 Bari 29 9 5 14 6 5 6 1 0 75 Bay 29 42 29 12 0 0 66 361 - 539 Galgaduud 0 0 78 65 54 161 89 0 257 704 3 1 3 1 3 0 0 3 - 14 Hiraan 1 0 0 1 1 8 3 6 12 32 8 9 10 7 8 12 7 11 10 82 Lower 26 13 42 13 14 9 10 11 7 145 Shabelle 6 4 5 6 10 5 3 7 7 53 Middle 6 9 4 4 4 0 0 17 - 44 Shabelle Mudug 131 31 87 46 12 6 8 11 12 344 Nugaal 31 27 24 19 20 0 27 0 32 180 Sanaag 18 5 8 70 11 13 8 6 10 149 Sool 40 16 29 35 50 31 31 50 27 309 Togdher 7 19 15 11 13 17 14 15 22 133 Waqoyi 7 11 11 17 11 10 21 29 9 126 Galbed Grand Total 430 283 424 410 277 343 355 586 447 3555

Measles Outbreak response

• Measles campaign is scheduled to take place in South Central and Somaliland. The campaign was conducted in Puntland in January 2018 with 92% administrative coverage. • The Preparation to conduct measles mass campaign in South and central zones is completed. It is planned 11th – 14th March 2018 targeting a total of 2,693,928 (6 Months to 10 years) aged children living in 66 accessible and partially accessible districts of South and central zone. 10 districts are inaccessible. • Somaliland is also planning to conduct the measles campaign during the same period and preparation is undergoing to vaccinate 1,400, 207 living in of the 19 districts in zone.

Table 5. Summary of epidemic prone diseases and syndromes in different districts of Somalia as of week 1-9, 2018

Regions District SARI ILI AWD BD OAD DIPH WC MEAS NNT AFP AJS VHF MAL MENG OC Total_cons Awdal Total 0 3168 11 48 1026 0 0 10 0 0 0 0 3 0 11581 15847 Baki 0 364 0 18 85 0 0 0 0 0 0 0 0 0 1010 1477 Borama 0 2107 11 27 658 0 0 6 0 0 0 0 2 0 7757 10568 Lughaya 0 63 0 2 52 0 0 0 0 0 0 0 0 0 525 642 Zeila 0 634 0 1 231 0 0 4 0 0 0 0 1 0 2289 3160 Bakool Total 38 3 0 23 148 0 5 102 0 0 0 0 189 0 19592 20100 Elberde 0 0 0 0 20 0 0 0 0 0 0 0 0 0 3667 3687 Huddur 5 0 0 8 33 0 0 1 0 0 0 0 54 0 2926 3027 Tayeeglow 0 0 0 0 18 0 0 6 0 0 0 0 24 0 586 634 Wajid 33 3 0 15 77 0 5 95 0 0 0 0 111 0 12413 12752 Banadir Total 2380 3957 404 0 5966 0 7 514 0 0 0 0 321 4 150136 163689 Abdiaziz 0 23 0 0 52 0 0 0 0 0 0 0 0 0 3138 3213 Boondhere 0 0 0 0 112 0 0 22 0 0 0 0 0 0 3240 3374 Dayniile 0 0 0 0 70 0 0 5 0 0 0 0 0 0 5724 5799 Dharkinley 257 522 0 0 839 0 0 30 0 0 0 0 0 0 8585 10233 Hamar Jab Jab 124 257 0 0 257 0 1 3 0 0 0 0 1 0 6180 6823 Hamar Weyne 49 101 0 0 450 0 0 8 0 0 0 0 0 0 3992 4600 Hodan 0 0 0 0 27 0 0 0 0 0 0 0 3 0 3317 3347 Howl-wadaag 0 0 0 0 0 0 0 5 0 0 0 0 1 0 12815 12821 Huruwaa 793 1796 0 0 1727 0 0 285 0 0 0 0 3 4 19466 24074 Kaaraan 10 69 0 0 46 0 0 1 0 0 0 0 0 0 7140 7266 Kahda 47 351 0 0 183 0 0 1 0 0 0 0 0 0 715 1297 Shibis 0 0 0 0 193 0 0 4 0 0 0 0 0 0 3097 3294 Waberi 0 0 0 0 26 0 0 0 0 0 0 0 0 0 6626 6652 Wadajir 727 779 404 0 1091 0 0 117 0 0 0 0 305 0 39015 42438 Wardhigley 10 0 0 0 523 0 6 21 0 0 0 0 8 0 16956 17524 Yaqshid 363 59 0 0 370 0 0 12 0 0 0 0 0 0 10130 10934 Bari Total 46 1020 3 10 511 0 0 75 0 0 0 0 335 0 18080 20313 Banderbayla 0 153 0 0 18 0 0 1 0 0 0 0 0 0 616 788

Bossaso 46 847 3 0 345 0 0 28 0 0 0 0 331 0 5536 7347 Carmo 0 6 0 0 4 0 0 0 0 0 0 0 2 0 491 525 0 0 0 0 19 0 0 0 0 0 0 0 0 0 1255 1274 Iskushuban 0 7 0 1 5 0 0 0 0 0 0 0 0 0 462 475 Qardho 0 0 0 9 84 0 0 38 0 0 0 0 2 0 5511 5644 Rakko 0 0 0 0 32 0 0 8 0 0 0 0 0 0 1770 1810 Ufeyn 0 7 0 0 2 0 0 0 0 0 0 0 0 0 374 383 Waciya 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2065 2067 Bay Total 163 160 20 56 160 8 0 178 0 0 0 0 291 0 25176 26212 Baidoa 163 160 14 22 153 8 0 158 0 0 0 0 265 0 22661 23604 Berdale 0 0 6 0 0 0 0 0 0 0 0 0 14 0 967 987 Burhakaba 0 0 0 34 7 0 0 20 0 0 0 0 12 0 816 889 Qasax dhere 0 0 0 0 0 0 0 0 0 0 0 0 0 0 732 732 Galgadud Total 1462 153 1 1 351 0 71 1065 0 0 0 0 286 2 19665 23057 Abudwak 653 17 0 0 63 0 19 544 0 0 0 0 27 1 4071 5395 Adado 238 72 0 0 99 0 14 210 0 0 0 0 104 0 3720 4457 Balanbale 71 10 0 0 18 0 11 93 0 0 0 0 47 0 981 1231 Dhuusamarreeb 306 14 1 1 56 0 0 98 0 0 0 0 43 0 5748 6267 El Bur 24 6 0 0 38 0 0 34 0 0 0 0 17 0 533 652 El Dere 132 11 0 0 69 0 9 50 0 0 0 0 23 1 3678 3973 Gelinsor 38 23 0 0 8 0 18 36 0 0 0 0 25 0 934 1082 Gedo Total 27 772 0 0 162 0 0 14 0 0 0 0 170 0 10392 11537 B/hawo 16 184 0 0 38 0 0 7 0 0 0 0 46 0 2624 2915 Doolow 7 220 0 0 45 0 0 2 0 0 0 0 39 0 2463 2776 Garbahaarey 1 138 0 0 25 0 0 0 0 0 0 0 31 0 2121 2316 Luuq 3 230 0 0 54 0 0 5 0 0 0 0 54 0 3184 3530 Hiraan 2307 1517 187 0 2398 0 2 32 0 0 0 0 58 1 26596 33098 Belet Weyne 1248 1128 187 0 1490 0 2 30 0 0 0 0 57 1 16776 20919 Bulo Burto 620 204 0 0 700 0 0 2 0 0 0 0 1 0 4312 5839 Jalalaqsi 361 51 0 0 156 0 0 0 0 0 0 0 0 0 1030 1598 Matabaan 50 88 0 0 29 0 0 0 0 0 0 0 0 0 2121 2288 Maxaas 28 46 0 0 23 0 0 0 0 0 0 0 0 0 2357 2454 Lower Total 417 0 29 35 449 1 12 82 0 0 0 0 55 0 25369 26449 Juba Afmadow 98 0 18 17 69 0 0 0 0 0 0 0 0 0 3287 3489

Hagar 40 0 0 0 44 0 0 20 0 0 0 0 0 0 1090 1194 Jamaame 39 0 6 2 56 0 0 26 0 0 0 0 18 0 2774 2921 Kismayo 240 0 5 16 280 1 12 36 0 0 0 0 37 0 18218 18845 Lower Total 259 217 0 2 1908 4 10 145 0 0 0 0 270 0 43328 46143 Shabelle Afgoi 13 46 0 0 119 0 0 21 0 0 0 0 4 0 8597 8800 Kurtunwarey 6 0 0 0 338 0 0 11 0 0 0 0 13 0 5341 5709 Marka 110 0 0 0 991 4 10 89 0 0 0 0 228 0 24556 25988 Qoryooley 27 0 0 0 217 0 0 23 0 0 0 0 22 0 4205 4494 Wanla Weyn 103 171 0 2 243 0 0 1 0 0 0 0 3 0 629 1152 Middle Total 25 0 0 21 197 5 94 53 0 0 0 0 58 0 3798 4251 Juba Bu'ale 5 0 0 2 48 0 24 13 0 0 0 0 0 0 735 827 Jilib 17 0 0 13 114 5 53 31 0 0 0 0 58 0 2438 2729 Salagle 3 0 0 6 35 0 17 9 0 0 0 0 0 0 625 695 Middle Total 19 295 8 38 1046 0 1 44 0 0 0 0 127 0 28911 30489 Shabelle Adale 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1429 1429 Bal'ad 1 272 0 14 268 0 1 27 0 0 0 0 61 0 12007 12651 Jowhar 10 0 8 24 569 0 0 17 0 0 0 0 59 0 8663 9350 Mahaday 0 15 0 0 74 0 0 0 0 0 0 0 4 0 2395 2488 Warsheikh 8 8 0 0 135 0 0 0 0 0 0 0 3 0 4417 4571 Mudug Total 146 36 10 14 921 3 24 344 17 0 18 0 8 1 43877 45419 Galdogob 2 0 1 0 76 0 0 1 0 0 1 0 0 0 2988 3069 Galkacyo 121 0 9 12 385 1 7 217 0 0 0 0 4 1 24621 25378 Harardere 23 36 0 1 85 0 12 29 0 0 0 0 4 0 1991 2181 Hobyo 0 0 0 0 338 2 5 90 17 0 17 0 0 0 8078 8547 Jariiban 0 0 0 1 37 0 0 7 0 0 0 0 0 0 6199 6244 Nugaal Total 63 704 0 0 340 1 4 180 0 0 0 0 0 0 9225 10517 Burtinle 1 136 0 0 90 0 0 29 0 0 0 0 0 0 1792 2048 Dangorayo 1 25 0 0 23 1 0 0 0 0 0 0 0 0 1029 1079 Eyl 12 205 0 0 79 0 0 44 0 0 0 0 0 0 2749 3089 Garoowe 49 338 0 0 148 0 4 107 0 0 0 0 0 0 3655 4301 Sanaag Total 402 290 0 0 362 1 73 149 0 0 0 0 19 1 11288 12663 Badhan 193 74 0 0 112 0 1 132 0 0 0 0 19 0 2201 2736 Dhahar 0 1 0 0 1 0 0 2 0 0 0 0 0 0 107 111 Eil-afweine 188 118 0 0 185 1 0 7 0 0 0 0 0 0 4467 4966

Erigavo 21 97 0 0 64 0 72 8 0 0 0 0 0 1 4513 4850 Sool Total 38 1503 0 2 987 0 23 309 0 0 0 0 22 0 13569 16453 Bocame 0 0 0 0 5 0 0 2 0 0 0 0 0 0 222 229 Hudun 0 263 0 0 139 0 1 13 0 0 0 0 0 0 1369 1785 Lasacanod 38 1117 0 2 809 0 22 292 0 0 0 0 22 0 10840 13142 Taleex 0 123 0 0 34 0 0 2 0 0 0 0 0 0 1138 1297 Togdher Total 165 1463 0 105 1063 0 8 126 0 0 4 0 2 7 11547 14490 Ainabo 1 54 0 19 64 0 0 0 0 0 0 0 0 0 848 986 Buhodle 22 79 0 34 83 0 0 4 0 0 0 0 0 0 1286 1508 Burao 119 1182 0 41 834 0 8 122 0 0 4 0 2 7 8515 10834 Odwayne 23 148 0 11 82 0 0 0 0 0 0 0 0 0 898 1162 Waqoy Total 379 3298 0 66 2078 0 82 133 0 1 14 0 9 7 20509 26576 Galbed Ballayabane 89 153 0 3 51 0 19 9 0 0 0 0 0 1 941 1266 Berbera 109 1198 0 2 822 0 51 79 0 1 14 0 0 1 6181 8458 Gabiley 50 949 0 34 605 0 3 13 0 0 0 0 2 0 2209 3865 Hargeisa 56 734 0 27 447 0 7 30 0 0 0 0 7 5 9593 10906 Sheikh 75 264 0 0 153 0 2 2 0 0 0 0 0 0 1585 2081 Grand Total 8336 18556 673 421 20073 23 416 3555 17 1 36 0 2223 23 492639 547303

SARI-Severe Acute respiratotyIllness,ILI-Influenza Like Illness,AWD-Acute Watery Diarrhoea,BD-Bloody Diarrhoea,Diph-Diptheria,WC-Whooping cough,Meas-Fever With Rash/Measles,NNT-Neonatal Tetanus,AJS-Acute Jaundice Syndrome,VHF-Viral HeamorrhagicFever,Mal-Confirmed Malaria,Men-Bacterial Meningi

For inquires please contact the Surveillance team, WHO country office in Somalia on address below: Dr.MutaaweLubogo, Epidemiologist,[email protected]